4 ms·
You have to look at it from the perspective of medical practice. The hypothesis is that inviting people for a regular check up reduces mortality. If a lot of p
by ricardobeat 4y ago
You have to look at it from the perspective of medical practice.
The hypothesis is that inviting people for a regular check up reduces mortality. If a lot of people don’t take up the offer because the procedure is too invasive, carries some risk, etc. then that is a very relevant variable to take into account. Vs, for example, fecal testing as mentioned in the article. It could have a lower precision, but if uptake is 100% instead of the ~40% for colonoscopy the outcomes could be much better.
- dis-sys 4y ago> then that is a very relevant variable to take into account. but that variable has nothing to do with whether the procedure itself is effective or not.
- bstpierre 4y agoThe question in this context is whether it’s an effective public health measure to recommend the procedure to a population: specifically, does it reduce the number of deaths over a given period? Whether it’s effective on an individual basis is a related, but different, different question.
- darkerside 4y agoBehavioral medicine
- seanmcdirmid 4y agoAmerican health insurance really screws the pooch here. If you go for a colonoscopy without a previous fecal testing, it is a diagnostic procedure that is fully covered by your insurance without triggering deductible and copay. However, if you go for fecal testing first and then they find something suspicious that warrants a colonoscopy, it is no linger considered diagnostic (you have a legitimate problem now) and deductible/copays apply. So in practice, doctors will tell you to just get the colonoscopy to save (your own) money.
- astura 4y agoYou're not really wrong, but you're using the wrong terms which is extremely confusing. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-coverage-laws.html https://www.cancer.org/cancer/colon-rectal-cancer/detection-... For asymptomatic people without abnormal stool, colon cancer tests are called "screening," never "diagnostic." "Screening" is covered without cost sharing. Colonoscopy, fecal tests, etc. >But if you have a screening test other than colonoscopy and the result is positive (abnormal), you will need to have a colonoscopy. Some insurers consider this to be a diagnostic (not screening) colonoscopy, so you may have to pay the usual deductible and co-pay.
- seanmcdirmid 4y agoThanks for the clarification. I didn’t really know the difference in the terms being thrown around, just the oddness in the billing.
- gregw2 4y agoYou are complaining about the rare situation where someone gets fecal scanning first (and I agree this leads to perverse incentives)... But here's what the real racket is... American healthcare considers the colonoscopy preventative so the exam is covered... but if they see even a single polyp and decide to cut it off to get checked whether it is benign or not, that is not preventative but is diagnostic and thus is not covered and costs you $$$ in copays.
- seanmcdirmid 4y agoHuh. I didn’t see that in my exam. They did a biopsy on one polyp, but I wasn’t charged for it.
- hef19898 4y agoHope results were of the non-worrisome kind!
- deleted 4y ago[deleted]